Candidate: Anne Murray, M.D., M.Sc., is a fellowship-trained geriatrician with a Masters in Epidemiology and a staff physician at Hennepin County Medical Center, a teaching hospital affiliated with the University of Minnesota. She is also an investigator with Nephrology Analytical Services, an epidemiology laboratory and repository for the NIH's United States Renal Data System (USRDS) database. Dr. Murray's immediate goal is to pursue research in the epidemiology and prevention of cognitive impairment in dialysis patients. Career Objectives: Dr. Murray's immediate career objectives include: 1) advanced coursework in neuropsychology, study design, longitudinal analysis, and ethical conduct of research, 2) work with her mentors to further develop her research skills in the area of cognitive impairment in renal disease through regularly scheduled meetings and directed readings, 3) conduct a three-year longitudinal study of the prevalence and progression of cognitive impairment in dialysis patients under the guidance of her mentors, 4) continue to conduct analyses on the epidemiology of dementia in dialysis patients using the USRDS database, and 5) during the last year of the award, develop a proposal to obtain funding for a prospective study of the incidence of and risk factors for cognitive impairment in patients with chronic kidney disease, formerly called chronic renal insufficiency. Dr. Murray's long-term career objective is to attain independence as an investigator in the area of epidemiology of cognitive impairment in renal disease and other chronic diseases. Research Plan: During the five-year award period, Dr. Murray plans to use findings from analyses of her pilot data and the USRDS database to conduct a prospective longitudinal study of the prevalence and progression of cognitive impairment in dialysis patients in the Twin Cities. The study will test the hypotheses that 1) dialysis patients have a higher prevalence of cognitive impairment than the general population, 2) the risk of cognitive impairment increases with duration in years of dialysis, and 3) age, Modified Mini-Mental State Examination (3MS) score at baseline, education, and history of stroke will be strong predictors of the rate of progression of cognitive impairment in dialysis patients. Subsequently, Dr. Murray plans to collaborate with her mentors to write a major proposal to examine the epidemiology of cognitive impairment in patients with chronic kidney disease.